AMI病人PCI术后2年内发生主要心血管不良事件的列线图模型构建及验证

罗钢; 高丽; 丁宏; 李胜辉; 翟康宁; 陈震

doi:10.13898/j.cnki.issn.1000-2200.2024.05.009

AMI病人PCI术后2年内发生主要心血管不良事件的列线图模型构建及验证

Construction and validation of a nomogram model for major cardiovascular adverse events in acute myocardial infarction patients within 2 years after percutaneous coronary intervention

摘要

摘要:
目的研究影响急性心肌梗死(AMI)病人经皮冠状动脉介入治疗(PCI)术后2年内发生主要心血管不良事件(MACE)的危险因素，构建列线图模型并验证。
方法回顾性分析AMI行PCI术病人491例临床资料，将病人以7∶3比例随机分为建模组345例和验证组146例。采用单因素和多因素logistic回归分析，对建模组病人2年内发生MACE的影响因素进行分析，构建列线图模型并进行验证。
结果单因素及多因素logistic回归分析显示，年龄、fQRS波、Gensini评分、中性粒细胞/淋巴细胞均为AMI病人PCI术后2年内发生MACE的独立影响因素(P＜0.05~P＜0.01)。经绘制列线图，建模组AUC为0.743，表明该模型区分度良好，H-L曲线拟合良好(χ²=3.827，P=0.922)，验证组AUC为0.720，提示模型准确度良好。
结论年龄、fQRS波、Gensini评分、中性粒细胞/淋巴细胞是AMI病人PCI术后2年内发生MACE的独立危险因素，构建的列线图模型具有良好预测作用。

Abstract:
Objective To study the risk factors of major adverse cardiovascular events in acute myocardial infarction (AMI) patients within 2 years after percutaneous coronary intervention (PCI), construct a nomogram model and verify it.
Methods The clinical data of 491 patients with AMI undergoing PCI were analyzed retrospectively.The patients were randomly divided into a modeling group of 345 cases and a validation group of 146 cases in a 7:3 ratio.The influencing factors of major adverse cardiovascular events in the modeling group within 2 years were analyzed by univariate and multivariate logistic regression analysis, and a nomogram model was constructed and verified.
Results Univariate and multivariate logistic regression analysis showed that age, fQRS wave, Gensini score and neutrophils / lymphocytes ratio (NLR) were independent influencing factors of major adverse cardiovascular events in AMI patients within 2 years after PCI (P < 0.05 to P < 0.01).The nomogram was drawn, and the AUC of the modeling group was 0.743, showing that the model had good discrimination, the H-L curve was well fitted (χ²=3.827, P=0.922), and the AUC of the validation group was 0.720, indicating that the model was accurate.
Conclusions The age, fQRS wave, Gensini score and NLR are independent risk factors for major adverse cardiovascular events in AMI patients within 2 years after PCI, and the nomogram model has a good predictive function.

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